Healthcare Provider Details

I. General information

NPI: 1053056986
Provider Name (Legal Business Name): LAUREN NICOLE WILLIAMS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LOMA LINDA UNIVERSITY HEALTH FAMILY MEDICINE 11234 ANDERSON STREET
LOMA LINDA CA
92354-2804
US

IV. Provider business mailing address

31951 DOVE CANYON DR
TRABUCO CANYON CA
92679-3718
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-6688
  • Fax:
Mailing address:
  • Phone: 949-557-0890
  • Fax: 949-557-0890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number22010
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: